Despite controversies, Iowa DHS' Foxhoven gives agency glowing marks

Jerry Foxhoven, director of the Iowa Department of Human Services, gives an upbeat report on his agency on Nov. 28, 2017, to Republican Gov. Kim Reynolds, during a budget presentation. Democratic legislators said later they disagreed with Foxhoven.
William Petroski/The Register

Although the Iowa Department of Human Services has been embroiled in several controversies over the past year, director Jerry Foxhoven gave a glowing assessment of his agency Tuesday in a budget presentation to Gov. Kim Reynolds.

Foxhoven, who has been on the job fewer than six months, described Iowa's Medicaid health care program for low-income patients as having high levels of customer satisfaction. He said it's one of the best states in the country for overall child well-being and for mental health treatment.

He said improvements are being made in child well-being and care, and in promoting community-based services. Moreover, DHS services are being provided efficiently, costing less than 3 cents on the dollar for field operations and less than 1 cent on the dollar for general administration, he added.

"I can tell you we have a terrific cadre of people ... They work really, really hard and they do a really great job," Foxhoven said.

Reynolds, a Republican who became the state's chief executive in May, didn't ask Foxhoven any questions after his presentation, but she praised his leadership and his efforts to seek feedback and improve the agency's culture.

"Thank you. You are making a difference," the governor said.

Foxhoven presented a budget proposal for the 2018 state fiscal year that requests $1.79 billion from the state's general fund, up from an estimated $1.69 billion in the current fiscal year. The proposal includes a request for 4,350 full-time employees, which is about the same as this year.

Later Tuesday, Democratic legislators who have criticized the privatization of the state's Medicaid program, shortcomings in mental health programs and the deaths of children adopted out of foster care, told the Des Moines Register they disagreed with Foxhoven's optimistic assessment of the department.

State Sen. Matt McCoy, D-Des Moines, described DHS as an agency in crisis. He said the department lacks enough social workers to monitor children and vulnerable adults, and he views the state's decision to turn Medicaid over to private managers to be a disaster.

“The entire structure of privatized Medicaid is collapsing. It is a Dumpster fire, and it continues to fail Iowans who have the greatest needs. I like Jerry Foxhoven. But I would tell Iowans to be very wary of a magician who believes in his own magic," McCoy said.

Sen. Pam Jochum, D-Dubuque, who has an adult daughter who is developmentally disabled, said Foxhoven has been receptive when she has called with issues regarding individuals with disabilities and mental illness. But she believes troubles within DHS are much larger in scope than just a handful of people.

“The problems are pretty wide and deep. We are still struggling in many ways with the privatization of Medicaid," Jochum said. "I am glad to hear that all of this is wonderful. But I must be living on a different planet."

Foxhovens cited a report by Wallethub.com, a personal finance website, that named Iowa as the second best state for health care. He pointed to research by J.D. Power, a global marketing information services company, which suggested Iowa's managed Medicaid customers have high levels of customer satisfaction, including provider choice and easy access to doctors and hospitals compared with other states surveyed.

The DHS director noted that Iowa ranked fifth overall in children's well-being and seventh in health of children in an annual report by the Annie E. Casey Foundation. He also said that the Mental Health in America 2017 Report shows that Iowa ranks seventh in the nation for mental health care. Since 2013, local and state governments in Iowa have invested about $2 billion in mental health and disability services, he added.

“Iowa is really a top-10 state for mental health care. This is something that seems to miss the discussion an awful lot," Foxhoven said. "While we still have a long ways to go, like every state does, we really are a top 10 state in the delivery of mental health care services."

Foxhoven also discussed regional efforts to address mental health and disability services in Iowa, and he described how an inpatient psychiatric hospital bed tracking system has been implemented. The number of staffed and available inpatient psychiatric beds has grown from 721 in January 2016 to 747 currently, he said.